Shushan Jacob in Southlake - Surgery Of The Hand
Shushan Jacob - NPI 1114119542
Shushan Jacob is a Surgery Of The Hand in Southlake, Texas. Shushan Jacob practices all healthcare services and medical treatments related to Surgery Of The Hand. The NPI Number for Shushan Jacob is 1114119542. The last update date is 2022-09-28.
Shushan Jacob's current location address is 2140 E Southlake Blvd Ste L-605, Southlake, Texas. You can contact this provider via phone number 8174044811 and fax number 8339742284. The mailing address for Shushan Jacob is 2140 E Southlake Blvd Ste L-605, Southlake, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shushan Jacob |
|---|---|
| Address | 2140 E Southlake Blvd Ste L-605, Southlake, Texas |
| Phone Number | 8174044811 |
| Fax Number | 8339742284 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1114119542 |
|---|---|
| Provider Enumeration Date | 2007-08-09 |
| Last Updated Date | 2022-09-28 |
Provider Mailing Address Detail
| Address | 2140 E Southlake Blvd Ste L-605 |
|---|---|
| City | Southlake |
| State | Texas (TX) |
| Post Code | 760926516 |
| Phone Number | 8174044811 |
| Fax Number | 8339742284 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery Of The Hand |
|---|---|
| Taxonomy | 2086S0105X |
| Licence No | N7548 |
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Definition: A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 286943004 | TX | -- | |
| 286943005 | TX | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Shushan Jacob by the Centers for Medicare & Medicaid Services?
The Shushan Jacob has been issued the NPI (National Provider Identifier) 1114119542. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Shushan Jacob's physical address?
The Shushan Jacob is physically located at 2140 E Southlake Blvd Ste L-605, in the city of Southlake, TX, with the postal code 760926516.
What is Shushan Jacob's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Shushan Jacob is Surgery Of The Hand, and the taxonomy code that categorizes this field of expertise is 2086S0105X.
On what date did the Centers for Medicare & Medicaid Services issue the 1114119542 to Shushan Jacob?
The Shushan Jacob received its 1114119542 assignment from the Centers for Medicare & Medicaid Services on 2007-08-09.
As of what date was the information regarding Shushan Jacob, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Shushan Jacob, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2022-09-28.